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2013—2023年济南市慢性病综合防控示范区与非示范区居民重大慢性病早死概率和疾病负担及其变化趋势比较

Comparison of the premature death probability and disease burden of major chronic diseases along with their changing trends between residents in chronic disease comprehensive control and prevention demonstration areas and non-demonstration areas in Jinan from 2013 to 2023

    摘要
  • 摘要:
    目的 比较山东省济南市慢性病综合防控示范区（示范区）与非示范区居民重大慢性病早死概率和疾病负担及其变化趋势，为提升居民健康水平提供参考。
    方法 收集中国疾病预防控制中心“人口死亡信息登记管理系统”中济南市3个示范区和3个非示范区2013—2023年居民心脑血管疾病（CVD）、恶性肿瘤、慢性呼吸系统疾病（CRD）和糖尿病（DM）四类重大慢性病死亡数据，比较示范区与非示范区居民四类重大慢性病标化死亡率、早死概率和标化过早死亡寿命损失年（YLL）率，并采用年均变化百分比（AAPC）比较其变化趋势。
    结果 济南市示范区居民CVD、恶性肿瘤、四大慢性病年均标化死亡率和标化YLL率均高于非示范区，CRD、DM年均标化死亡率和标化YLL率均低于非示范区，CVD（AAPC= –1.33%，95%CI= –2.21%～–0.46%）、恶性肿瘤（AAPC= –3.33%，95%CI= –4.47%～–2.18%）、CRD（AAPC= –6.69%，95%CI= –8.29%～–5.07%）、四大慢性病（AAPC= –2.22%，95%CI= –2.94%～–1.50%）标化死亡率以及CVD（AAPC= –1.66%，95%CI= –2.50%～–0.81%）、恶性肿瘤（AAPC= –3.96%，95%CI= –5.23%～–2.68%）、CRD（AAPC= –7.41%，95%CI= –9.12%～–5.67%）、四大慢性病（AAPC= –2.73%，95%CI= –3.42%～–2.04%）标化YLL率均呈下降趋势且降幅大于非示范区；示范区居民恶性肿瘤和四大慢性病年均早死概率均高于非示范区，CVD、CRD和DM年均早死概率均低于非示范区，CVD（AAPC= –1.70%，95%CI= –2.57%～–0.82%）、恶性肿瘤（AAPC= –3.60%，95%CI= –4.80%～–2.39%）、CRD（AAPC= –5.81%，95%CI= –7.90%～–3.68%）和四大慢性病（AAPC= –2.56%，95%CI= –3.36%～–1.75%）早死概率均呈下降趋势，且降幅大于非示范区。
    结论 济南市示范区建设可降低CVD、恶性肿瘤和CRD早死负担，30～69岁人群获益明显，但DM防控仍需加强。

     

    Abstract:
    Objective To compare the premature death probability and disease burden of major chronic diseases along with their changing trends among residents in chronic disease comprehensive control and prevention demonstration areas (demonstration areas) and non-demonstration areas in Jinan city, thus providing a basis for improving the residents′ health.
    Methods Using mortality data from three demonstration areas and three non-demonstration areas in Jinan, 2013 – 2023, we compared and analyzed age-standardized mortality rates (ASMR), premature mortality probability, and standardized years of life lost (YLL) rates of cardiovascular diseases (CVD), malignant tumors, chronic respiratory diseases (CRD), and diabetes mellitus (DM). The changing trends were assessed based on the average annual percentage change (AAPC).
    Results The demonstration areas had higher average ASMR and standardized YLL rates of CVD, malignant tumors, and the four major chronic diseases and lower average ASMR and standardized YLL rates of CRD and DM than the non-demonstration areas. Significant declining trends were observed for the ASMR of CVD (AAPC = –1.33%, 95%CI: –2.21% to –0.46%), malignant tumors (AAPC = –3.33%, 95%CI: –4.47% to –2.18%), CRD (AAPC = –6.69%, 95%CI: –8.29% to –5.07%), and the four major chronic diseases (AAPC = –2.22%, 95%CI: –2.94% to –1.50%) as well as the standardized YLL rates of CVD (AAPC = –1.66%, 95%CI: –2.50% to –0.81%), malignant tumors (AAPC = –3.96%, 95%CI: –5.23% to –2.68%), CRD (AAPC = –7.41%, 95%CI: –9.12% to –5.67%), and the four major chronic diseases (AAPC = –2.73%, 95%CI: –3.42% to –2.04%), with greater declines in the demonstration areas. The demonstration areas had higher average annual premature death probabilities of malignant tumors and the four major chronic diseases and lower average annual premature death probabilities of CVD, CRD, and DM than the non-demonstration areas. Reductions in premature death probability were observed for CVD (AAPC = –1.70%, 95%CI: –2.57% to –0.82%), malignant tumors (AAPC = –3.60%, 95%CI: –4.80% to –2.39%), CRD (AAPC = –5.81%, 95%CI: –7.90% to –3.68%), and the four major chronic diseases (AAPC = –2.56%, 95%CI: –3.36% to –1.75%), with greater declines in the demonstration areas.
    Conclusions The establishment of demonstration areas in Jinan has significantly reduced premature death burden from CVD, malignant tumors, and CRD. These interventions have shown pronounced benefits for the people aged 30–69. Nevertheless, the prevention and control of DM still need to be strengthened.

     

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